New Oral Anticoagulants versus Warfarin for Cerebral Venous Thrombosis: A Multi-Center, Observational Study / 대한뇌졸중학회지

No abstract available.

Clinical Presentations and Phenotypic Spectrum of Multiple Sclerosis at a University Hospital in Saudi Arabia

BACKGROUND AND PURPOSE: The objective of this study was to determine the frequencies of different clinical presentations and the phenotypic spectrum of multiple sclerosis (MS). METHODS: This cross-sectional study was performed in the Neurology Department of King Fahd Hospital of University Alkhobar in the Kingdom of Saudi Arabia (KSA). Data of 190 MS patients who fulfilled the McDonald criteria were retrieved from medical records and analyzed. RESULTS: The age at disease onset was 26.27±8.2 years (mean±SD) and disease duration was 6.38±5.10 years. The male-to-female ratio was 1:1.6. Optic neuritis and myelitis were the most-frequent first clinical presentations. Sensory (73.1%), motor (61%), and visual (58.4%) symptoms were the most-frequent established clinical symptoms. Relapsing-remitting multiple sclerosis (RRMS) was present in 75% of the cases. Supratentorial T2-weighted white-matter lesions and deep-gray-matter or juxtacortical lesions were the most-frequent magnetic resonance imaging (MRI) lesions, comprising 28% and 23.7% of all MRI lesions observed in 93.6% and 79.4% of the cases, respectively. The scores on the Expanded Disability Status Scale were within the range of 1.0–5.5 in 82.1% of the patients. There were 145 (76.3%) patients taking interferon β therapy. CONCLUSIONS: MS presenting in the hospital setting is more common in KSA than reported previously, and the number of diagnosed cases in increasing. It is therefore an emerging and disabling neurological illness in KSA with clinical characteristics not dissimilar to those in other middle eastern countries. A decrease in the frequency of patients with secondary progressive multiple sclerosis (SPMS) indicates either that more new cases of RRMS are being diagnosed or that adequate treatments of RRMS are preventing the evolution to SPMS. Further larger and population-wide epidemiological and clinical studies with the long-term follow-up of MS patients are required to better assess the clinical spectrum of MS in KSA.

Relationship between glycated haemoglobin and carotid atherosclerotic disease among patients with acute ischaemic stroke

Objectives: This study aimed to determine the relationship between glycaemic control and carotid atherosclerotic disease among patients with acute ischaemic stroke [AIS]

Methods: This retrospective crosssectional study took place in the Neurology Department of King Fahad Hospital of University, Khobar, Saudi Arabia, from April to October 2017. Data were collected from the medical records of 244 patients with a diagnosis of AIS confirmed by computed tomography. Doppler ultrasounds of the carotid artery were performed to determine the presence of increased carotid intima media thickness [CIMT] and plaques

Results: Significantly higher mean glycated haemoglobin [HbA1c] levels were noted in cases with high CIMT values [P = 0.002], but not in cases with carotid plaques [P = 0.360]. In addition, there was a significant association between diabetes mellitus [DM] and high CIMT [P = 0.045], but not with carotid plaques [P = 0.075]. Finally, while dyslipidaemia and age were independently correlated with high CIMT values [P = 0.034 and <0.001, respectively] and carotid plaques [P <0.001 each], no independent relationships were noted in terms of gender and other risk factors like DM, hypertension and smoking [P >0.050 each]

Conclusion: High HbA1c levels were associated with high CIMT values, but not with carotid plaques. Therefore, HbA1c levels may be useful as an indirect marker of the initial stages of carotid artery atherosclerosis

Cigarette smoking and consumption of psychotropic drugs among medical students of Rawalpindi Medical College, Rawalpindi

Objective: To evaluate practice of cigarette smoking and use of psychotropic drugs among medical students of Rawalpindi Medical College, Rawalpindi

Study design, settings and duration: Descriptive cross sectional was done at Rawalpindi Medical College, Rawalpindi during June 2010

Subjects and Methods: A descriptive cross sectional study was carried out among all medical students Rawalpindi Medical College who were present in various classes during June 2010. Informed consent was taken from all students and data gathered through self-administered questionnaire. Information gathered included consumption of psychotropic drugs, initial mode of getting cigarettes, place of smoking, age of initiation of smoking on regular basis, number of cigarettes smoked per day, cessation of smoking and past smoking history. Data was analyzed using SPSS version 20

Results: A total of 975 students agreed to fill the questionnaire and returned it. Out of them, 815 students denied the consumption of any such drug. No response was received from 86 students while 74 [7.6%] were using psychotic drugs which included various stimulants [31] and sedatives and hypnotics [43]. There were 234 [24%] cigarette smokers whose mean age of initiation of smoking on regular basis was 19.5 years. The place of buying cigarette was either shops or street vendors [21%]. Almost 42.7% medical students smoked cigarette in the medical college while 23.1% smoked in public places, 8.9% at friend's house and 8.1%, in social events. Most [48.7%] medical students had tried at least one cigarette in the medical college to see its effect. There were 98 current smokers [84 males and 14 females] out of whom 50 [21.3%] were current daily smokers. Of the total 234 smokers, 46.1% were not willing to quit smoking within next 6 months

Conclusion: In the medical college 24% students were smokers and 7.6% were using psychotropic drugs. Almost 46% students were not willing to quit smoking in near future

Policy message: Regular medical checkups are needed in medical students for their indulgence in addictions like tobacco use and psychotropic drugs. Once convinced and practicing, they can better guide their patients and populations coming to them for various health issues